Barnes Jewish Hospital—Center for Advanced Medicine ST. LOUIS, MO

The design team for the Center for Advanced Medicine started with the concept of the patient experience, initiated by the idea of arrival and wayfinding. Good wayfinding is particularly important within the outpatient environment because of the large number of first-time facility users. Five main “patient experience” zones—arrival, lobby, elevators, nodes, and destination—were defined, and each of these space types was given specific guiding principles and a defining vocabulary system.

The intent of the Center for Advanced Medicine is to consider the patient's needs first. Instead of moving the ambulatory patient around to various centralized functions, services are decentralized to come to the patient. This concept of “one-stop shopping” supports the patient-first approach and addresses the goals of operational efficiency and convenience.

Within the interior spaces, a clinic module was used as a planning template for the building, creating tremendous flexibility and allowing departments to change locations or expand without major renovation to the space. The departments operate similarly, so that staff can “flex” between groups easily, depending on staffing needs. Also, instead of designing a custom process for each of the departments, the planning focused on creating the ideal patient experience and then made variations as required by particular groups.

The building systems are conceived to provide flexibility for future change. The ideas for future change began with a structural system that is designed to seismic-resistive standards that exceed the current building codes, thus allowing the medical center's facilities to remain operational in the event of a major seismic occurrence. Mechanical systems are designed in zones for relatively smaller areas per floor per building, to allow not only operational differences, but also functional-use differences. The building is completely wired with a fiberoptic system that provides the ability to connect electronically to all rooms, affording not only access to diagnostic and treatment results, but also to future electronic medical records.

Project challenges included phased construction and operational issues. A tight urban site congested with years of building and no open space necessitated phased implementation of construction. To create sites for the new buildings, a plan was needed to demolish existing buildings, requiring the consolidation and relocation of departments, services, and people. The acute care hospital, children's hospital, and one of the leading research and teaching medical schools in the country had to be kept operational during the relocation process. Additionally, the design team faced the physical challenge of keeping the Metrolink transit system, which bisects the medical campus underground, running throughout the project.

The design provides an accommodating medical facility for patients and staff. The staff can deliver seamless care by integrating a whole variety of systems for medical support services, such as registration, scheduling, medical records, and other information systems.

The design goal was to make the Center for Advanced Medicine as patient-friendly as it could be.